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Racial Inequality in the Prime of Life: Infectious Disease Mortality in U.S. Cities, 1906-1933
Aja Antoine-Jones1, James J Feigenbaum2, Lauren Hoehn-Velasco3
1University of California, Berkeley, Berkeley, CA 94720, USA.
Social Science History
|December 16, 2024
Summary
Infectious disease deaths declined in US cities, but racial disparities grew. Declining waterborne disease deaths lowered overall mortality, while unequal tuberculosis mortality increases widened racial inequality.
Area of Science:
- Public Health
- Epidemiology
- Urban History
Background:
- Infectious disease mortality significantly decreased in early 20th-century American cities.
- Rising life expectancy and falling infant mortality were accompanied by increasing racial disparities in disease-related deaths.
- Urban environments experienced complex demographic and epidemiological shifts during this period.
Purpose of the Study:
- To analyze the dual trends of declining infectious disease mortality and increasing racial inequality in US cities during the early 20th century.
- To identify the specific infectious diseases contributing to these opposing trends.
- To understand the mechanisms driving changes in both overall mortality rates and racial disparities.
Main Methods:
- Historical epidemiological analysis of urban mortality data.
- Comparative study of infectious disease trends between racial groups.
- Examination of the impact of specific diseases (e.g., waterborne diseases, tuberculosis) on mortality rates and disparities.
Main Results:
- A significant reduction in urban infectious disease mortality occurred for both Black and white populations, primarily due to decreased deaths from waterborne diseases.
- The decline in waterborne disease mortality had a minimal impact on the overall racial disparity in infectious disease mortality.
- Tuberculosis mortality declined unevenly across racial groups, particularly affecting those of prime age and significantly widening racial inequality in infectious disease mortality.
Conclusions:
- The fall in overall infectious disease mortality in US cities was driven by factors like improved sanitation, which disproportionately benefited white populations.
- Widening racial inequality in infectious disease mortality was exacerbated by the differential impact of diseases like tuberculosis, highlighting persistent social and economic disparities.
- Public health interventions and outcomes were not uniformly distributed across racial lines, leading to divergent mortality trends.
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